A new study says the world needs four million more health workers to improve public health. Southern Africa alone needs an estimated one million more health workers just to meet the Millennium Development Goals. These United Nations goals aim to improve health by two thousand fifteen.

The study is by a group of health and development organizations called the Joint Learning Initiative. The Lancet in Britain published the results.

The researchers estimate that more than one hundred million people work in health care worldwide. But the study says only about one-fourth of these people are trained as doctors, nurses or midwives. The others are believed to be traditional, community or other kinds of health workers.

The study examines the way skilled professionals are spread throughout the world. For example, it says sub-Saharan Africa has one-tenth as many nurses and doctors for its population as Europe has. Italy has fifty times as many as Ethiopia has.

The study blames several things. First is the AIDS crisis. Health workers face more work and the danger of infection. The study says many no longer act as healers but as providers of care for the dying.

Second is the so-called “brain drain” of skilled workers from poor nations to countries that can pay them more. And third is a lack of enough investment in health workers in many countries.

But the study says official development assistance is finally increasing after ten years. Currently, about four thousand million dollars a year in foreign aid for health is spent on human resources, such as pay and training. The researchers say foreign aid providers must work together to better organize their investments. They say ten percent, or four hundred million dollars, should go toward workforce development.

The study also suggests better use of resources such as paraprofessionals. These are people trained to do much of the work of doctors, including some operations. But they are not doctors, so there is less chance they might leave for wealthier countries that need doctors.

Lincoln Chen at Harvard University in Cambridge, Massachusetts, helped write this call for action. What we do or fail to do today, he says, will shape the direction of world health in the twenty-first century.

This VOA Special English Development Report was written by Jill Moss. This is Gwen Outen.